NPI | 1790135176 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IA G166263) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 140640) |
Enumeration Date | 2016-06-16 |
Last Update Date | 2021-11-16 |